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Covered California for Small Business –
New Blue Shield Plans

Starting July 1, Covered California for Small Business (CCSB) is offering new Blue Shield plans, providing more options for enrollees. These plans include the Access+ HMO Network with Platinum, Gold, and Silver metal tier options, as well as the Bronze Trio HMO 7000/70. The two most popular Blue Shield High Deductible Health Plans (HDHP), Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans, are also now available.

All of these plans offer benefits such as Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.

For assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.

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Small Business Tax Credit

I’ve been told that Covered California for Small Business is an option only for employers eligible for the Small Business Health Care Tax Credit. Is this correct?

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No, that’s incorrect. Covered California for Small Business is a health insurance marketplace that offers any California small business (1-100 employees) a choice of quality, affordable health insurance from multiple trusted carriers.

A wide range of California employers benefit from the many advantages offered by Covered California for Small Business. Discover the advantages here.

Are employer premiums paid toward dependent coverage included in the calculation for the small business tax credit? Is the employer required to pay at least 50% of dependent coverage to be eligible to claim the credit?

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An employer may include amounts paid toward dependent coverage when determining employer premiums paid for purposes of the small business tax credit. To get the credit, an employer is not required to pay for all or even a portion of dependent coverage, but to the extent the employer pays these amounts, they may be included in employer premiums paid when calculating the credit.  Additionally, the employer will not fail to satisfy the uniform percentage requirement by contributing different amounts toward dependent coverage under I.R.C. § 45R.

What is the Marketplace Identifier employers should use on IRS Form 8941 when claiming the tax credit?

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Assuming they purchased coverage through Covered California for Small Business (CCSB), the CCSB market identifier is: 0CA (the first character is a zero).

What is an FTE?

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An FTE is a full-time equivalent employee. For purposes of the tax credit, a full-time employee is one that works on average 40 hours per week or 2,080 hours per year. So for example two 20-hour/week employees = 1 FTE. To calculate the number of FTE’s, add up all hours worked (max hours/employee is 2,080, even if they worked OT) and divide by 2,080. If the result is a fraction, then round down to the nearest whole number.

If the employer takes the credit in tax year 2014, can they skip 2015 and take the credit again in 2016 or later?

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No, the tax credit must be taken in two-consecutive taxable years. If the employer takes the credit in 2014, and does not take the credit again in 2015, they lose the ability to take the credit again in future years.

Under the ACA, how many years will the tax credit be available?

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Two-consecutive taxable years beginning in 2014 or later, for which the eligible small employer files an income tax return with an attached Form 8941. If the small business took the tax credit in the 2013 tax year or earlier, that does not count as part of the two-consecutive tax years.

Are owners and/or partners exempt from the $50K income average?

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Yes. Employees do not include independent contractors (including sole proprietors), partners in a partnership, shareholders owning more than 2% of an S-corp, and any owners of more than 5% of other businesses. Employees also do not include family members of the owners and partners. Family members include a child (or descendent of a child); a sibling or step-sibling; a parent (or ancestor of a parent); a step-parent; a niece or nephew; an aunt or uncle; and in-laws. A spouse of any of these family members is also considered a family member.

Is whether or not a group took the tax credit in past years going to have any bearing on their estimate for this year? 

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Whether they took the tax credit in past years will NOT impact the amount or ability to take the tax credit this year. If they took the tax credit last year (2013), they may not realize that to take the credit again in 2014, they will HAVE to be in a SHOP plan. That was not a requirement in 2013, so this is a change they need to be aware of.

Are Seasonal Workers included in the calculation?

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Interesting guidelines from the IRS on Seasonal Workers. Provided the worker is employed less than 120 days, they are not considered employees for purposes of the tax credit and don’t need to be included in the FTE and average wage calculations. However, if the employer paid for their healthcare coverage while they were employed, the employer can add premiums paid for their coverage to the total premiums paid when calculating the tax credit.

My client owns a number of businesses, they all file separate taxes. Can they each qualify for the tax credit?

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The “controlled group” concept applies when calculating FTE’s and average wages. Generally, if the same five or fewer individuals own 80% or more of the companies, then the FTE’s and average wages must be aggregated.

In our library, you’ll find carrier forms, applications, enrollment kits, broker bonuses, marketing resources, and more (video tutorial). However, not all carrier forms are available online.

If you don’t find what you are looking for, contact our team for help at 800.696.4543 or materials@claremontcompanies.com.